Respiratory care is set to improve after being given a national focus in the new NHS Long Term Plan, says PCRS Executive Chair Dr Noel Baxter.
The document highlights late diagnosis, variation in service provision, geographic and socio-economic inequalities, rising emergency admissions and poor international comparisons as challenges to be overcome.
Tackling chronic breathlessness and tobacco addiction feature significantly and represent a new way of thinking, something which PCRS has been campaigning on for some years.
- Improve diagnosis by training and certifying more staff in primary care to perform and interpret spirometry to reduce the variation and quality of spirometry testing.
- Increase access to pulmonary rehabilitation (PR) services in both community and hospital locations to prevent 500,000 exacerbations and avoid 80,000 admissions using a population management approach to find more eligible patients. New models will be established to provide rehabilitation and self-management support to patients with mild COPD, including digital tools. More patients will be referred to PR through the use of COPD hospital discharge bundles.
- Explore the idea of a combined PR service with cardiac patients to tackle common symptoms of breathlessness
- Optimise medication including making better use of pharmacists to review medication, improve the use of inhalers, and support the uptake of new smart inhalers.
- Reduce the burden of pneumonia on the NHS by making more consistent use of risk scoring for deteriorating patients, and community based care to avoid admissions.
- Provide a greater focus on supporting people with tobacco dependency to quit smoking, particularly when admitted to hospital and notably for those suffering from severe mental illness who are then more likely to live unhealthy and shortened lives due to respiratory illness.
The plan offers increased funding for primary and community care of at least £4.5bn. Primary and community care teams will be encouraged to work more collaboratively in ‘primary care networks’ to increase the services they provide jointly; there will be a focus on providing more integrated care and preventing illness.
The national plan will be followed by development of local organisation plans by April. Five year local system strategies are expected to be published by the summer.
Dr Baxter said: “PCRS welcomes this national recognition of the need to move respiratory care up the agenda. PCRS members can help shape what the NHS Long Term Plan means for their area by discussing how local services need to be developed to deliver this national strategy. People can make their views known either through their own provider organisations, CCGs and newly forming Integrated Care Systems, by discussing issues in their local affiliated groups or on social media. Having the respiratory community championing the respiratory agenda locally will really make a difference.”